Kelli Lauren Coon, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9117165 Issued in FL

Practice address

1920 Don Wickham Dr Ste 215
Clermont, FL 34711-1977

Phone

(352) 437-8049

Fax

(352) 394-8804

NPI assigned

Mar 3, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

70.4 of 100Reported as group

Quality

47.82

Promoting interoperability

97

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Networks

• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: kelli.coon.1@8042.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Privia Medical Group Florida, LLC

  • General Practice Physician
  • Indialantic, FL
  • NPI 1700649043
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1677801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678924800000",
    "number": "1154021756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15280 NW 79TH CT STE 200",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330165873",
            "telephone_number": "305-558-3724",
            "fax_number": "786-907-4485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 DON WICKHAM DR STE 215",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347111977",
            "telephone_number": "352-437-8049",
            "fax_number": "352-394-8804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COON",
        "first_name": "KELLI",
        "middle_name": "LAUREN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-03",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9117165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kellicoon@sfa.allscriptsdirect.net",
            "affiliation": "Y",
            "affiliationName": "Florida ENT Associates, Inc.",
            "address_1": "1920 Don Wickham Dr Ste 215",
            "city": "Clermont",
            "state": "FL",
            "country_code": "US",
            "postal_code": "347111977",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Julie M Conrad, ARNP
• Conscious Change,LLC
• Shaunagh Diana Cook, APRN, FNP-C
• Marianna Cookshott, MS
• Caitlin Elizabeth Coole, MS, CCC-SLP
• Bakeisha Payton Cooper
• Cora Health Services Inc
• Angela Christina Corallo, OTR/L
• Natalia Cordeiro, LMFT
• Lilian Cordero

• Physician Assistant in Clermont, FL
• Providers in Clermont, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.